Metropolitan Life Insurance Company

U.S. Life Insurance Claims
Metropolitan Life Insurance Company
Metropolitan Tower Life Insurance Company
New England Life Insurance Company
MetLife Insurance Company USA
First MetLife Investors Insurance Company
General American Life Insurance Company
On behalf of MetLife, please accept our sincere condolences during this difficult time.
Helping you submit your claim
We’ve enclosed a “Guide to making your claim” which describes the steps to submit your claim. You have the
option to receive the proceeds of your claim deposited into a convenient Total Control Account that we’ll open
for you, or as a check. You’ll find more details in the enclosed document, “About the Total Control Account.”
We’re here to help
We recognize this may be a challenging time for you. If you have questions, or need help preparing your claim,
call us at 1-800-MET-5000 (1-800-638-5000). Our Customer Service Center is open Monday through Friday,
9:00 a.m. to 6:00 p.m. EST.
Sincerely,
MetLife
U.S. Life Insurance Claims
IND-LTR (03/15)
Page 1 of 1
Fs
U.S. Life Insurance Claims
Guide to making your claim
What you’ll find in this package
• Life insurance claim form – You’ll need to complete and return this to us with the death certificate.
• About the Total Control Account – This explains the option you have to receive your claim proceeds.
To submit your claim, follow these steps:
1. Decide
You have the following options to receive your life insurance proceeds:
• A Total Control Account that we open for you to hold your claim proceeds, or
• A check that we mail to you
Please read the enclosed About the Total Control Account for details and other settlement options that may be
available to you. Please indicate your choice when completing the claim form. If you do not choose an option,
you will receive a Total Control Account in most states unless state law requires us to pay you by check.
2. Complete
Complete the enclosed Life insurance claim form by following the instructions on the form. Please provide all
the information requested so we may process your claim as quickly as possible.
3. Return
Please send us your completed claim form and the documents we ask for in Section 6 of the form.
What to expect after you submit your claim
We’re committed to processing your claim as quickly as possible. Once we receive all your information,
we’re able to process a typical claim within 5-7 business days.
If we approve your claim and you chose to receive a check, or your proceeds are less than $5,000, we’ll mail
you the check.
If you choose to receive your proceeds in a Total Control Account, we’ll:
• Open a Total Control Account in your name
• Place the proceeds from your claim into your account, and
• Mail you a package, that includes account details and a book of personalized drafts (like checks)
IND-CLAIM-GUIDE (03/15)
Page 1 of 1
Fs
U.S. Life Insurance Claims
About the Total Control Account®
A convenient place to hold the proceeds from your claim while you decide what to do with the money
How the account works
The Total Control Account (TCA) is a draft account that works like a checking account:
• When your account is open, MetLife1 will send you a package which includes additional details about the
TCA. We pay the full amount owed to you by placing your proceeds into the TCA and providing you a book of
drafts. You can use the drafts like you would use checks.
• You can use a single draft to access the entire proceeds or several drafts for smaller amounts (as little as
$250). There are no limits on the number of drafts you can write. Processing time is similar to check
processing.
• You earn interest on the money in your account from the date your account is open.
• We’ll send you an account statement each month when there is activity in your account. If you have no
activity, we’ll send you a statement once every three months.
• You can name a beneficiary for your account. We’ll include a beneficiary form in the package we send you
when we open your account.
Interest rates and guarantees
The interest rate on your account is set weekly, and will always be the greater of the guaranteed rate stated in
your TCA package, or the rate established by one of the following indices: the prior week’s Money Fund Report
Averages™/Government 7-Day Simple Yield, or the Bank Rate Monitor™ National Money Market Index. We
calculate interest daily and compound it, so you earn interest on your interest. The interest is added to your
account monthly. The interest earnings generally are taxable so you should speak with your tax advisor.
No monthly maintenance fees
There are no monthly maintenance or service fees on your TCA, no charges for making withdrawals or writing
drafts, and no cost for ordering additional drafts. You may be charged for special services or an overdrawn
TCA, and the current fees (subject to change) for those are: draft copy $2; stop payment $10; wire transfer $10;
overdrawn TCA $15; overnight delivery service $25.
1
“MetLife” means Metropolitan Life Insurance Company or the MetLife affiliate that issued the underlying policy
IND-TCA (03/15)
Page 1 of 2
L0315414004[exp0317][All States] Fs
Other important information
• Your Total Control Account is backed by the financial strength of MetLife. The assets backing the funds are
held in MetLife’s general account and are subject to MetLife’s creditors. In addition, while the funds in your
account are not insured by the FDIC, they are guaranteed by your state insurance guarantee association.
The coverage limits vary by state. Please contact the National Organization of Life and Health Insurance
Guaranty Associations (www.NOLHGA.com or 703-481-5206) to learn more. FOR FURTHER INFORMATION,
PLEASE CONTACT YOUR STATE DEPARTMENT OF INSURANCE.
• If there is no activity on your account for a period of time (typically three years, but this may vary by state), state
regulations may require that we contact you at the address we have on file. If we aren’t able to reach you,
we may be required to close your account and transfer the funds to the state.
• We may limit or suspend your access to the funds in your account if we suspect fraud or if there was an error
in opening your account.
• We use the services of The Bank of New York Mellon, 701 Market Street, Philadelphia, PA 19106, for Total
Control Account recordkeeping and draft clearing.
• A TCA generally is not available if your claim is less than $5,000, you reside in a foreign country, or if the
claimant is a corporation or similar entity.
• The insurance policy may have provided other settlement options for payment of your proceeds. The options
listed below may not be available under all circumstances. Your right to elect these options may be
preserved if you elect a TCA. Some settlement options are: Interest Income, Installment Income for a Stated
Period, Installment Income for a Stated Amount, Single Life Income - Guaranteed Payment Option, Single
Life Income - Guaranteed Return, and Joint and Survivor Life Income. You can reference the policy for more
details.
• We may receive investment earnings from operating the Total Control Account. The performance results of
any investments we make do not affect the interest rate we pay you.
• To learn more about TCA, please call us at 800-638-7283 (TDD callers: 800-229-3037) or write us at
Metropolitan Life Insurance Company, Total Control Account, PO Box 6100, Scranton, PA 18505-6100,
Attention: TCA.
Total Control Account® is a registered service mark of Metropolitan Life Insurance Company.
IND-TCA (03/15)
Page 2 of 2
L0315414004[exp0317][All States] Fs
Claim Fraud Warnings
Before signing this claim form, please read the warning for the state where you reside and for the state where
the insurance policy under which you are claiming a benefit was issued.
Alabama, Arkansas, District of Columbia, Louisiana, Massachusetts, Minnesota, New Mexico, Ohio,
Rhode Island and West Virginia: Any person who knowingly presents a false or fraudulent claim for payment
of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and
may be subject to fines and confinement in prison.
Alaska: A person who knowingly and with intent to injure, defraud, or deceive an insurance company files a
claim containing false, incomplete or misleading information may be prosecuted under state law.
Arizona: For your protection, Arizona law requires the following statement to appear on this
form. Any person who knowingly presents a false or fraudulent claim for payment of a loss is
subject to criminal and civil penalties.
California: For your protection, California law requires the following to appear on this form: Any person who
knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject
to fines and confinement in state prison.
Colorado: It is unlawful to knowingly provide false, incomplete or misleading facts or information to an
insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include
imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance
company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or
claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a
settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance
within the Department of Regulatory Agencies.
Delaware, Idaho, Indiana and Oklahoma: WARNING: Any person who knowingly, and with intent to injure,
defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false,
incomplete or misleading information is guilty of a felony.
Florida: A person who knowingly and with intent to injure, defraud or deceive any insurer files a statement of
claim or an application containing any false, incomplete or misleading information is guilty of a felony of the third
degree.
Kentucky: Any person who knowingly and with intent to defraud any insurance company or other person files a
statement of claim containing any materially false information or conceals, for the purpose of misleading,
information concerning any fact material thereto commits a fraudulent insurance act, which is a crime.
Maine, Tennessee, Virginia and Washington: It is a crime to knowingly provide false, incomplete or
misleading information to an insurance company for the purposes of defrauding the company. Penalties may
include imprisonment, fines or a denial of insurance benefits.
Maryland: Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or
benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime
and may be subject to fines and confinement in prison.
New Hampshire: Any person who, with a purpose to injure, defraud or deceive any insurance company, files a
statement of claim containing any false, incomplete or misleading information is subject to prosecution and
punishment for insurance fraud as provided in R.S.A. 638.20.
New Jersey: Any person who knowingly files a statement of claim containing any false or misleading
information is subject to criminal and civil penalties.
Oregon and Vermont: Any person who knowingly presents a false statement of claim for insurance may be
guilty of a criminal offense and subject to penalties under state law.
Puerto Rico: Any person who knowingly and with the intention to defraud includes false information in an
application for insurance or files, assists or abets in the filing of a fraudulent claim to obtain payment of a loss or
other benefit, or files more than one claim for the same loss or damage, commits a felony and if found guilty
shall be punished for each violation with a fine of no less than five thousand dollars ($5,000), not to exceed ten
thousand dollars ($10,000); or imprisoned for a fixed term of three (3) years, or both. If aggravating
circumstances exist, the fixed jail term may be increased to a maximum of five (5) years; and if mitigating
circumstances are present, the jail term may be reduced to a minimum of two (2) years.
Texas: Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a
crime and may be subject to fines and confinement in state prison.
Pennsylvania and all other states: Any person who knowingly and with intent to defraud any insurance
company or other person files an application for insurance or statement of claim containing any materially false
information or conceals for the purpose of misleading, information concerning any fact material thereto commits
a fraudulent insurance act, which is a crime and subjects such person to criminal or civil penalties.
Page 1 of 1
EFRDCLM-96-15 (03/15)
Fs
U.S. Life Insurance Claims
Life insurance claim form
Use this form to submit your claim for a life insurance policy payment.
Things to know before you begin
• Each beneficiary submitting a claim must complete and submit a
separate claim form. However, we only need one death certificate.
Metropolitan Life Insurance Company
Metropolitan Tower Life Insurance Company
New England Life Insurance Company
MetLife Insurance Company USA
First MetLife Investors Insurance Company
General American Life Insurance Company
Please correct and initial
any errors on the form.
• Please answer each question fully and accurately. If you return this
form with missing or incorrect information, it will delay your claim.
SECTION 1: About you
Your name (first, middle, last) - Please print your name the way you want it to appear on your payment.
First
Middle
Last
Maiden name
Relationship to the insured
Mailing address (Street number and name, apartment or suite)
City
State
ZIP code
Date of birth (mm/dd/yyyy) Sex (M/F) Social Security number
Country of Citizenship
Please tell us if you would like to receive claim statuses electronically* (check the box and provide information)
Phone number
Cell phone number
Email address
I consent to receive claim status e-mails and text messages as indicated above.
*Please see the enclosed About Electronic Statusing in Section 6 for more details.
SECTION 2: About the deceased
First name
Middle
Last
Residence address (Street number and name, apartment or suite)
Maiden name
City
State
Date of birth (mm/dd/yyyy)
Marital status:
Single
Date of death (mm/dd/yyyy)
Married
Divorced
Separated
ZIP code
Social Security number
Widow/widower
SECTION 3: About your claim
Please list the policy number and suffix (if applicable) for all policies you’re making a claim on
ECLM-96-15
Page 1 of 4
(06/16) Fs
SECTION 4: Tell us how you want to receive your claim payment
Check one:
You’d like us to put your payment into a Total Control Account that we’ll open for you.
You’d like to receive a check for your payment.
Add any special instructions or comments you have for us here.
• For more information about the Total Control Account, please read “About the Total Control Account.”
• Keep in mind once you receive a check you cannot get a Total Control Account
• If your payment is less than $5,000, or you are not a U.S. citizen or resident for tax purposes, we will
automatically pay you by check.
• If you don’t choose a payment option, you will receive a Total Control Account, unless state law, rule or
regulation requires us to pay you by check.
For Illinois residents and policies issued in Illinois only – By law, we’re required to process and pay your life
claim within 31 days of the receipt of the insured’s death certificate. If we don’t make a payment to you within
this time, your life claim amount will accumulate interest at the rate of 10% annually, calculated from the date
the person died, to the date the total amount due to you is paid.
SECTION 5: Certification and signature
By signing this claim form, you certify that:
• All the information you have given is true and complete to the best of your knowledge.
• If we overpay you, we have the right to recover the amount we overpaid. This can happen if we find we’ve
paid you more than you’re entitled to under this life insurance claim, or if we paid you when we should have
paid someone else. You agree to repay us the amount we overpaid. You also understand that if you do not
repay us, we may take steps, including legal action, to recover the overpayment.
• You have read the Claim Fraud Warnings included with this form. New York residents: Any person who
knowingly and with intent to defraud any insurance company or other person files an application for
insurance or statement of claim containing any materially false information, or conceals for the purpose of
misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a
crime, and shall also be subject to civil penalty not to exceed five thousand dollars and the stated value of
the claim for each such violation.
Under the penalties of perjury I certify:
1. That the number shown as my Social Security Number in “Section 1: About you” is my correct taxpayer
identification number, and
2. That I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I
have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as
a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer
subject to backup withholding, and
3. I am a U.S. citizen, resident alien, or other U.S. person*, and
4. I am not subject to FATCA reporting because I am a U.S. person* and the account is located within the
United States.
(Please note: You must cross out Item 2 above if the IRS has notified you that you are currently subject to backup
withholding because you failed to report all interest or dividend income on your tax return.)
*If you are not a U.S. Citizen, a U.S. resident alien or other U.S. person for tax purposes, please
complete form W-8BEN (individuals) or W-8BEN-E (entities).
The Internal Revenue Service does not require your consent to any provision of this document other than the
certifications required to avoid backup withholding.
Signature of person making the claim
ECLM-96-15
Date signed (mm/dd/yyyy)
Page 2 of 4
(06/16) Fs
SECTION 6: How to submit this form
6A. Check off the items you’re sending with this claim form
Death certificate. If your claim is for more than $100,000, we require a certified death certificate. A
certified death certificate has a raised or colored seal on it. The funeral director taking care of the
funeral arrangements can usually arrange to have the death certificate certified. We only require one
death certificate – if you’re aware of another claimant who’s sending one, you don’t have to send it.
Policies for which you’re making a claim.
If you signed a document with a funeral home that authorizes us to make a payment directly to them, a
copy of that document.
If the person died in an accident and you’re making an accidental death benefit claim, proof of the
accident - police reports and other supporting documents.
If you have Power of Attorney, a copy of the appointment papers naming you as the attorney-in-fact for
the beneficiary.
About Electronic Statusing
MetLife provides electronic statusing as a convenience to you. Please review the following terms and
conditions carefully before provide (a) your agreement to them, and (b) your consent to receiving electronic
statuses.
By agreeing to the terms of this Agreement, you are consenting to receive claims statuses in one or more of the
following ways:
1. When a change has been made to your claim, we will send you an email advising you that we have made
such a change;
Such e-mails will be sent to the current e-mail address we have on file for you. In addition, we can notify you
about the availability of claim statuses by text messages (SMS - Short Messaging Service). If you agree to
receive notification of the availability of claim status messages by text message, you acknowledge and agree
that any charges associated with your receipt of these messages are fully your obligation and are not
reimbursable by MetLife of any of its affiliates. There may be other third party costs for Internet access fees
of text message (SMS) charges that are not reimbursable by MetLife or any of its affiliates.
We will continue to deliver information in writing to you by U.S. mail.
2. You may withdraw your consent, change your delivery preferences, and update information we need to
contact you electronically at any time by replying "stop" to a text message from us or by calling our Customer
Service Department.
ECLM-96-15
Page 3 of 4
(06/16) Fs
6B. Please mail your completed claim to the following address:
MetLife Customer Service Center
P.O. Box 330
Warwick, RI 02887-0330
800-638-5000
New England Life
P.O. Box 542
Warwick, RI 02887-0542
800-388-4000
General American Life Insurance Company
PO Box 355
Warwick, RI 02887-0355
800-638-9294
MetLife/New England Life
(Equity Products Only)
P.O. Box 353
Warwick, RI 02887-0353
800-638-5000 - MetLife
800-388-4000 - New England Life
General American Life Insurance Company
(Equity Products Only)
PO Box 356
Warwick, RI 02887-0356
800-638-9294
MetLife Insurance Company USA/First MetLife Investors
(Equity Products Only)
P.O. Box 358
Warwick, RI 02887-0358
800-638-5000
MetLife Insurance Company USA/First MetLife Investors
P.O. Box 354
Warwick, RI 02887-0354
800-638-5000
Please mail first two pages of this form, fully completed and signed, to avoid delays.
We're here to help
If you have questions, or need help preparing your claim, call us at 1-800-MET-5000
(1-800-638-5000). Our Customer Service Center is open Monday through Friday,
9:00 a.m. to 6:00 p.m. EST.
Some services in connection with your claim may be performed by our affiliate, MetLife Global Operations Support Center
Private Limited. This service arrangement in no way alters the above MetLife Companies’ obligations to you. Services will
not be performed by our affiliate if prohibited by state or local law.
ECLM-96-15
Page 4 of 4
(06/16) Fs